Comparison the efficacy of cefazolin plus gentamicin with cefazolin plus ciprofloxacin in management of type -IIIA open fractures

The optimal antibiotic regimen is still controversial in open fractures. The purpose of this study was to evaluate the efficacy of two different antibiotic regimens in management of type III-A open fractures. From January 2001 to January 2008, patients with type IIIA open fractures admitted in Shahid Beheshti Hospital Affiliated to Babol University of Medical Sciences were enrolled. Patients randomly received cefazolin plus gentamicin [group I] or cefazolin plus ciprofloxacin [group II]. Both regimens were administered for 3 days. All patients were followed for 3 months. The efficacy of both regimens was compared. One hundred-forty eight and 153 patients were treated in group I and II, respectively. The mean age of the patients treated in group I was 36.96 +/- 14.4 and in group II was 36.93 +/- 13.51 years. The rate of deep infection in group I was 5.4% and in group II was 6.5%. The efficacy of regimen I was 94.6% and regimen II was 93.5%. Cefazolin plus gentamicin, or cefazolin plus ciprofloxacin both can be successfully used for prevention of infection in type IIIA open fractures

[Evaluation of the risk factors of diabetic foot ulcer and its treatment in diabetic patients, Babol, North of Iran]

Diabetic foot ulcer is one of the major complications of diabetes mellitus patients occurring in 15% of these individuals. The aim of this study is to evaluate the risk factors of diabetic foot ulcer and determine its treatment in diabetic patients. This cross-sectional study was performed on 100 diabetic patients with foot ulcer, hospitalized in the Shahid Beheshti and Yahayanejad hospitals in Babol from 2003 to 2004. Information was collected with two questionnaires, one for demographic characteristics and the other covering the risk factors of diabetic foot ulcer and its treatment. Data was analyzed by SPSS software, P values <0.05 were considered significant. There was no significant difference between gender and smoking, or alcohol consumption and obesity [p>0. 05]. Foot ulcer occurred incidentally in 66% of patients and in 18%, foreign bodies were the cause. Seventy-three percent of patients [27 males and 46 females] had abnormal foot structure, revealing a significant difference between sex and abnormal foot structure [P=0. 001]. Although diabetic foot ulcer cannot be prevented, but controlling the risk factors and educating people, can significantly decrease the incidence rate and morbidity

Pattern of motorcyclist's mortality in Mazandran province, northern Iran

Road traffic accidents [RTA] is recognized internationally as the major threat to human health and, motorcycle collision victims form a high proportion of those killed or injured in RTA.This study was performed to evaluate the patterns of motorcyclist's mortalities. All motorcyclists' corpses that were presented to the legal medicine center of Mazandaran Province during January 2002 to January 2004 were enrolled and the patterns of motorcyclist's mortalities were determined. Of the 89 bodies, 93.3% were male and 84.2% were riders. About 60% sustained injuries from collision with a car. Two third of the deaths occurred in the first half of the year. Three fourth of the death occurred in heavy traffic volume time of a day [7 am to 10 pm] peaking at 9 pm [21%]. Fifty seven percent died on the rural roads collisions and 47% on the urban road collisions. Head injury was the main cause of death [50.6%]. Motorcyclist's mortalities were prevalent in young motorcycle riders [males], collision with a car, first half of the year, heavy traffic volume time, riding on rural roads, and head injury was the main cause of death

Outcome of osteotomy of coracoid process in treatment of recurrent shoulder dislocation

According to the high prevalence of recurrent anterior and traumatic shoulder dislocation, different methods have been suggested for treatment. This study was conducted to evaluate the outcome of surgery of coracoid osteotomy and fixation to anterior glenoid. This quasi-experimental study was performed on 43 patients suffering anterior dislocation of shoulder from 1993 to 2004 in Babol. All patients were treated by coracoid transfer and fixation to glenoid by its incision and passing through subcapsular muscle without manipulation on articular capsule. Fixation was done with velpo for 21 days and the rehabilitation performed by physiotherapy program. Outcome was evaluated by different radiographics, range of motion, absence or presence of continuous and night pain, recurrence dislocation, muscle atrophy and returning to normal activity. Mean age of patients was 26.09 +/- 6.3 years. Three to twenty eight dislocations were reported. There were no recurrence after surgery and the mean time for returning to normal activity was 7.7 +/- 1.5 months. Average loss of external rotation and flexion were 8 degrees compared with normal side. Continuous pain after surgery was seen in one patient due to screw loosing that was repaired with screw extraction. Results show that this procedure had good success in treatment of recurrent and traumatic shoulder dislocation. Comparative studies with other procedures are required to evaluate the results of this procedure

Primary chondromatosis of subacromial bursa; A case report

Synovial chondromatosis is a rare disease. It occurs as primary or secondary lesion with involvement of joint, tendon and bursa [extra articular] or combined. We present a case of subacromial chondromatosis with presentation of a large cystic lesion with rapid growth and containing numerous chondral particles. The patient was a 16 year old boy admitted with a huge mass at right shoulder which was begun since 3 months. Sonography and CT scan showed a mass of 7 x 10 x 4 cm, which contained small particles. The patient was operated and a very large cystic mass with numerous rice bodies in it was removed. Pathologic examinations revealed primary synovial chondromatosis. Synovial chondromatosis should be considered in differential diagnosis of cystic masses around the joints especially shoulder